VDU Blog: A Deeper Look At The MacIntyre MERS-CoV Paper

Credit FAO

 

 

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Yesterday, in  Debating A Controversial MERS Paper, we looked at a rebuttal in the online academic forum The Conversation - by researchers @influenza_bio, @MackayIM, @maiamajumder, @neva925, @stgoldst & @kat_arden -  of a controversial paper by Professor Raina MacIntyre  that suggested that the  `human release’  of MERS-CoV could be behind the erratic outbreaks we’ve seen in the Middle East.

At just over a thousand words, this rebuttal was geared for the general reader, and so a lot of details were glossed over.

 

Today Dr. Mackay and company have posted a much longer analysis of the MacIntyre paper – one that runs well over 3,000 words – which dissects the MacIntyre paper more thoroughly. 

 

While acknowledging that bioterrorism is always `possible’, they argue that – based on the evidence – it  is an extremely unlikely scenario for MERS.

 

Follow the link below to read:

 

Virus variability, dopey data and insufficient infection control do not support the theory that bioterrorism is behind the ongoing MERS-CoV outbreak.

A collaborative note from (alphabetically): @influenza_bio, @MackayIM, @maiamajumder, @neva925, @stgoldst, @kat_arden

Majumder: An Asymptomatic MERS Transmission Scenario

Interactive MERS map – Source Maia Majumder

 

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Several days ago on twitter Maia Majumder posited a unique method by which mild or asymptomatic carriers of the MERS virus might transmit the virus to others – particularly in a Middle Eastern hospital situation.  I confess, ever since hearing her idea, I’ve been intrigued.  

 

Maia characterizes her idea as a SWAG, meaning she has no proof – just a hunch, but believes that the scenario deserves investigation.  

 

Today I’m happy to say, she has fleshed out her ideas and has presented them on her blog Mens et Manus.   Follow the link to read:

 

Asymptomatic MERS + Ablution = Transmission?

Asymptomatic MERS has been a hot topic lately.

Since the onset of the current outbreak, 22% of all reported diagnoses – 60 of 279 total – have been asymptomatic. Of those 60, over half of them have been healthcare workers (HCW) [1].

In fact, the data thus far indicates that healthcare workers are far more likely to have asymptomatic MERS than members of the general public. 32 of the 69 healthcare workers that have been diagnosed since March 20th have been asymptomatic [1].

(Continue . . . )

 

While you are at Mens et Manus, take the time to look at Maia’s other offerings, including her interactive MERS map at and her tumblr account http://maiamajumder.tumblr.com/.

Referral: Majumder On MERS Mortality & Comorbidity In Symptomatic Cases

Credit Mens et Manus blog

 

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We’ve recently seen a significant drop in the apparent mortality rate of the MERS coronavirus – at least, based on the limited (and often delayed) information we’ve been getting out of the Middle East.   While `good news’, the reality is the CFR (case fatality ration) remains disturbingly high.

 

While at first this drop in mortality seemed likely due to the greater number of asymptomatic cases reported over the past month, Maia Majumder – working on her Mens et Manus blog –  has done a terrific job teasing out the data, and finds the answer is a bit more complicated than that.

 

Follow the link below to read Maia’s analysis:

 

 

MERS: Mortality & comorbidity in symptomatic cases

After posting my recently updated charts on mortality and comorbidity rates among MERS cases, I received several questions regarding why there’s been such a sudden drop-off in both since the onset of the current outbreak. Here they are for quick reference:

Some have been suggesting that this might be the case because of the large number of asymptomatic cases that have been diagnosed since March 20th. As of today, exactly 2/3 of all asymptomatic MERS cases have been reported during the current outbreak – 52 of 78 total. This is a sensible hypothesis, given that 97% of asymptomatic cases thus far have occurred in individuals without pre-existing conditions and none of them have ended in death.

(Continue . . . )

 

The bottom line, as well illustrated by Maia’s work, is that younger and healthier people are increasingly making up a part of the symptomatic MERS patient pool.  Since healthier people are more likely to survive any illness than those without serious comorbidities, the fatality rate has begun to decrease.

 

As to why we are seeing this shift in patient demographics now . . .

 

Well, that’s just one of the unanswered $64 questions with this emerging virus.  One, that hopefully can be resolved now that the Saudi MOH seems more engaged in pursuing the epidemiological investigation into this outbreak. 

Stay tuned.